Georgia program launches assistance to help uninsured meet Pathways Medicaid work requirement

Pathways offers Medicaid health insurance in exchange for completing 80 hours per month of work, job training, volunteering or other eligible activities.

“First Step Staffing Services, the beauty of what they bring to the table as it connects to our applicants is for folks who say, hey, I’m ready to get into the workforce, into the job pipeline. And so it connects those prospective members to employment opportunities and employers that are interested in hiring and supporting individuals that we serve collectively,” said CareSource Georgia President Jason Bearden.

Many applicants in this situation, he said, are transitioning out of difficult circumstances that hamper their ability to land a steady job.   

“Homelessness, criminal justice involvement, where folks are coming out of incarceration, poverty situations,” Bearden said, “they’re struggling to put meals on the table.” 

CareSource administers Medicaid plans for more than 450,000 people across the state. 

Bearden said the additional assistance in qualifying for Pathways is especially important for Medicaid recipients who lose their traditional coverage as part of the ongoing Medicaid redetermination process, also known as Medicaid ‘unwinding.’ 

So far in Georgia, during the state’s unwinding, at least 56,068 adults and children have lost regular Medicaid because they are deemed ineligible. Another at least 333,658 have lost it for so-called procedural reasons, including missed deadlines or paperwork issues.

Pathways got underway this summer, making Georgia the only state in the country with a partial expansion of Medicaid with a work mandate.

It offers coverage to adults who meet the work requirements, with incomes up to 100% of the federal poverty line of $14,580 for a single person or $30,000 for a family of four.

And so far, Pathways’ growth has been sluggish. State data show fewer than 1,400 people signed up in the first three months.

Gov. Brian Kemp’s administration’s initial projections were for roughly 90,000 people to enroll in Pathways’ in the first year.  

“We will continue working to educate Georgians about Pathways’ innovative, first-of-its-kind opportunity and enroll more individuals in the months to come,” said spokesman Garrison Douglas.

He said the state Department of Community Health is processing another 12,000 new applications.

However, Georgia health advocates have expressed skepticism that people initially accepted to Pathways could sustain participation in the long term.

They, along with a coalition of General Assembly Democrats, continue to push for full Medicaid expansion under the Affordable Care Act, which has been estimated to cover roughly 450,000 uninsured Georgians with incomes up to 138% of the federal poverty line, or $20,120 annually for a single person and $41,400 for a family of four.

Instead, Kemp has opted for piecemeal Medicaid eligibility expansions, including Pathways and the state’s recent 12-month extension for postpartum women.  

And Pathways had a rocky beginning.

The Trump administration approved Kemp’s plan for Pathways. It was then blocked by the Biden administration in 2021. The state then sued the federal government.

Last year, a federal judge at the U.S. District Court for the Southern District of Georgia in Brunswick allowed Pathways to become a reality.

CareSource reported enrolling about 750 people into Pathways since its launch this summer.

To up that number, CareSource this week also announced a new partnership with Goodwill Southeast Georgia to give people eligible for Pathways additional access to education and job training, and employment opportunities.

“Embracing a comprehensive, person-centered strategy to workforce development, Goodwill provides more than training and employment – we are committed to uplifting the individuals we serve,” said Veronica Styron, vice president of Mission Services at Goodwill Southeast Georgia.